Basic Information
| Provider Information | |||||||||
| NPI: | 1477919272 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MESSICK | ||||||||
| FirstName: | MELANIE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MS, LPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 616 | ||||||||
| Address2: | |||||||||
| City: | CLINTON | ||||||||
| State: | IL | ||||||||
| PostalCode: | 617270616 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2179359496 | ||||||||
| FaxNumber: | 2179354508 | ||||||||
| Practice Location | |||||||||
| Address1: | 200 MAINE ST STE A | ||||||||
| Address2: | |||||||||
| City: | LAWRENCE | ||||||||
| State: | KS | ||||||||
| PostalCode: | 660441396 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7858439192 | ||||||||
| FaxNumber: | 7858432219 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/08/2016 | ||||||||
| LastUpdateDate: | 02/22/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | 3339 | KS | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.